Paramedics made my father go to hospital

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My father has atrial fibrillation. He has had this for years.

He has been told multiple times what to do in the case of an episode of AF. Today, he had one while I was visiting. It took a long time to pass, so in line with his consultant’s plan my mother called 999, after the usual medications had been given at home.

In the time it took for the paramedics to arrive, the attack passed and when they did arrive, it had been nearly an hour since it had ended.

They still made him go to hospital as they “couldn’t rule out a heart attack”, despite my father insisting that he knows his body, knows what an AF episode feels like and knows when it has passed. All he wanted was to go to bed and sleep off the effects of the beta blockers he had taken.

They still essentially made him go to hospital, saying that they would make him sign forms if he didn’t which showed he had refused medical advice. I was present and the paramedics essentially made it sound as though he would be at the back of the queue if it returned and he needed an ambulance again.

Fast forward 10 hours and he’s still in hospital, no doctors available to read his ECG or his blood test results, and he’s been sleeping in a hard plastic chair. AIBU to think this is ridiculous? Paramedics really shouldn’t be encouraging patients to attend hospital when it’s not necessary.

We’re going through a situation different to yours but in a way similar. My partners mum is in sheltered accommodation and in October fell over but couldn’t get up because she can only use one arm. She wasn’t hurt in any way but the carer called an ambulance and she went to hospital where she was checked over and found to be ok. However it took us over 5 months to get her out of hospital because social services got involved and kept refusing to send her home, saying she was a falls risk. His mum has now spent 5 months in various care facilities whilst she is supposedly being assessed but has been left in bed 90% of the time in a nappy making her virtually immobile and has put in lots of weight so it’s harder for her to move. She has very little medically wrong with her despite having a stroke many years ago. We dread her going into hospital again because the medical people just refuse to listen to us, the people that know her best. Therefore I’d agree with the OP, the patient knows their own body best in times like that.

Calling an ambulance in this instance was the right thing to do. Although having waited for such a long time it may have been much quicker for you (or someone) to drive him to the hospital. Once the episode subsided you were going to call to cancel but the ambulance had arrived, they did all the usual checks and it appeared from the ECG that there was nothing indicating an immediate admission was necessary. However an ECG only shows what happening at that moment, not what may have happened earlier when you called. To find that out, blood tests need to be undertaken at hospital. They would have advised your father to go to hospital. IF he chooses not to, that's absolutely his decision and he would need to sign paperwork to confirm that he was acting against the advice of the paramedics and he fully understood the potential consequences. This is applicable for anyone who refuses to attend hospital against paramedics advice. It sounds as if they were busy - given the time it took for someone to arrive, they will have stated that absolutely another ambulance would be sent BUT it very likely would take some time if there was no-one immediately available. Under those circumstances they obviously felt it was more appropriate and safer for you dad to be in a hospital environment where they could rule out an earlier heart attack and also be readily available should your dad take a turn for the worse. Hearts are unpredictable and he could very easily have had a major heart attack and consequently a cardiac arrest. Their advice was based on their knowledge and experience. What would be the objective of a complaint??? Would you rather they do not take someone who has an unstable heart condition to hospital? And if that person has a cardiac arrest and dies? Your dad is fine by the sounds of it - making a complaint would be detrimental to the NHS and the paramedics involved, would serve no positive purpose because the position will remain exactly the same - if you have an unstable heart condition and call an ambulance the advice will always be - you need to be seen in hospital. Please don't underestimate their knowledge and experience, it's far more than most people realise. They will have carried out CPR on far to many people and they were only wanting the best for your dad.

There’s no way you ‘wouldn’t get an ambulance later’ but I’m guessing that they wouldn’t be too impressed having to come back to you if you declined their suggestion to go in to hospital when they attended the first time, understandably! If he really didn’t want to go in then maybe he should have just signed the paperwork to say he was happy to take the risk. And next time definitely cancel the ambulance if the episode has finished and he would decline A&E.

i don’t really think it’s right to call an ambulance, not cancel it at the point it’s not needed, then refuse the treatment they offer, what a waste of resources.

Its also perfectly ok to self discharge, they’ll want you to sign more paperwork there but I’m sure they’d find someone to take the cannula out if you said that you were leaving.

I’m a paramedic. Obviously I wasn’t on your father’s call, however, I can already strongly state you’re BU. A few observations:

• An ECG machine is a marvellous thing. It tells us if you’re in a funny heart rhythm or if there’s a complete blockage in one of the arteries supplying blood to your heart. It does not necessarily tell us if you’re having a partial occlusion of one of these vessels. The only way to rule that out (an impending BIG heart attack) is to have bloods done in hospital, specifically ones that look for troponins; which are released from the damaged heart muscle.
• Fast AF (which is likely what caused the “AF attack”), is a peri-arrest rhythm. Aka one of the rhythms your heart goes into just before it goes “nah love, I’ve had enough, I’m giving up”. Cardiac arrest beckons. Your father may well/is highly likely to have been in this rhythm and luckily it self resolved. Normal AF does not have “attacks”.
• If the crew had not advised further investigations into any damage from this episode and he’d died in the night, they’d risk being struck off. Let alone the devastation you would feel at losing a family member.

Are we sure this just isn’t due to the “inconvenience” it’s now caused you? You’re delayed being seen in ED because there are people in there who are sicker. Doesn’t mean he doesn’t need seeing though.

I’m appalled that you feel that the paramedics doing their job is reason for complaint. As a manager of ambulance crews, I can assure you that every complaint takes hours upon hours of meetings, paperwork and time spent on them. If we weren’t having to do these things, we’d be booked on alongside crews going to 999 calls. Not to mention the stress on the crew when they have probably already seen horrific things in this block of shifts. I really hope you have a long hard think about what the outcome could have been if they’d left him at home. As perhaps they’d be writing coroner’s statements then.

Honestly people do this ALL the time. They look at you like you have two heads when we say “you need to go to hospital as we’ve reached the limitations of what we can test and assess you for in the prehospital environment, and we have continued concerns”. When asking the patient what their expectations were if not hospital, the response is usually “best to get checked over”. Yep, you have been, and advised to go to ED. Then they sign a refusal and cuss us out the door.

But what else was in the plan? That’s also stated, but @Tiddlywinky has a selective reading issue.

My thoughts exactly!
This thread may give me a heart attack at this rate.
Ungrateful bastards.

You've called for an ambulance and refused to go to hospital for monitoring or treatment, essentially wasting their time. Obviously they aren't going to attend a second time!

They are an underfunded resource at the best of times, they aren't going to piss about with someone who refuses to follow advice or let them do their job. They'll prioritise those who they can actually help.

If he wasn't going to hospital because he knew it was just a AF attack, why call in the first place? Why not cancel when the attack subsided, an hour before? What exactly did you expect them to do without taking him in?

Were they really telling him that? Or were they trying to gently point out that if there’s an event in your town that always ‘turns mucky’ they might not have any ambulances to send to him if he’s having a heart attack and needs one urgently?

I understand that it’s going to be frustrating for him and for your family. But they’re doing the best they can with the limited resources they have available to them. If you aren’t happy with how they’ve handled it, you need to moan at your MP and ask what they’re doing to lobby for the NHS to be prioritised.

If he'd been treated quickly, with care, as soon as he arrived at hospital, and then sent home asap, would you still be unhappy?

Surely the real problem here is that old people are left sitting in seats (sometimes in corridors) for hours. Sorry, days sometimes (yes, I do know this for a fact).

Or a home visit from a GP would surely have been useful? To do the checks and confirm AE wasn't needed?

Unless you are medically qualified, i think c
paramedics will know more about AF than you.

PS I rushed the above so did also want to add, OP (honestly, I'm a bit horrified at myself that I didn't put this in the first place - I was multi-tasking, but it really has made me realise, social media's an evil influence on me, so apologies)...

I am also very sorry for your dad's experience, and fully appreciate your anger at him being kept waiting at his age and in that way to the degree he was. The point I was (retrospectively, far too directly) making was: I still really wouldn't blame the paramedics for this unless they were explicitly and directly unpleasant and threatening. They're working under huge pressure in a job most of us couldn't contemplate doing, attempting to juggle impossibly limited resources. Maybe, instead, you could write a letter to the hospital, or (as they were probably doing their best in awful circumstances, too), better still, to your MP (for what good it ever does!)

Regardless, I hope you're all feeling a bit better now and that any future medical treatment for any of you goes more smoothly. X

Unbelievable. People like this make me despair.

A GP would not have been able to rule out a problem.

"I should like to complain that the paramedics tried to ensure my father was in the best possible place, and had the best possible care for his condition".
False alarm ... THIS TIME.

A lot of people seem to be jumping on op saying to just find a staff member to get discharged. The reality from having been to hospital with my elderly mom is that there are no staff available to ask for things. Curtains are put around every patient, you ask a passing nurse and they run by saying that the doctor will be round soon. You overhear a doctor in the next cubicle bullying an elderly man on his own into signing a dnr even though he repeatedly says he would want to be resuscitated if necessary! The nhs is under a lot of pressure and although I am sure all the staff are doing their best to follow protocol , the most vulnerable patients and relatives are clearly not feeling safe and reassured.

A lot of people seem to be jumping on op saying to just find a staff member to get discharged. The reality from having been to hospital with my elderly mom is that there are no staff available to ask for things. Curtains are put around every patient, you ask a passing nurse and they run by saying that the doctor will be round soon. You overhear a doctor in the next cubicle bullying an elderly man in his own into signing a dnr even though he repeatedly says he would want to be resuscitated if necessary! The nhs i under a lot of pressure and although I am sure all the staff are doing their best to follow protocol , the most vulnerable patients and relatives are clearly not feeling safe and reassured.

oP said consultant plan said to call an ambulance to go to hospital and get checked out didn’t she?

”he’s to call 999 to attend hospital for beta blockers and potentially a cardioversion.”

I get the episode had resolved….so main question is why didn’t they cancel the ambulance?

You can always ignore 5% of anything in polling, So that leaves 13% who didn't read the OP

But how is anybody ill-informed?

It isn't Toddlywinky's job to rewrite an entire post for your benefit?

Well said. Thank you for this sane and informative post, and for everything you do.

The paramedic will not face suspension as they have not done anything wrong but followed procedures. All OPs complaint will do is waste NHS time and resources and make the affected individuals angry/ frustrated and keen to leave their chosen profession!
I have worked as a clinician in the NHS for 40 years and it never ceases to amaze me how ridiculous and entitled some people can be. Luckily I am now retired

Except by your own admissions earlier that isn’t what was said.

They (supposedly) said if he called again later he’d be at the back of the queue. Not that one wouldn’t be sent.

TeaPot496 We can’t win either way can we 🙄 if something had of happened to the patient, like an undiagnosed issue/co-morbidity, you can see the headlines in the papers right now, or are you the editor of one 🤬🤬🤬

I got out after nearly 20 years and it’s people like the OP which may be exceedingly glad I don’t work for the nhs anymore.